Plugged in to a new life

Plugged in to a new life

Dr. Anson Cheung, assisted by Dr. Michael Yamashita and Dr. Mary Lynn Brumwell, performs a transplant of left ventricular assist device to the heart of patient Edward Watson of Richmond on July 16 at St. Paul’s Hospital.Photo by
Jason Payne

Richmond lawyer Craig Watson no longer looks like a bloody, sawn-open carcass. Four days after open-heart surgery to install a titanium pump in his failing heart, the 45-year-old married father of three is sitting up in bed at St. Paul’s Hospital, his chest wired and sutured back together, the battery and control pack for the heart pump lying beside him.

He’s still in pain, but his eyes are bright.

Cardiac nurse Carrie Bancroft, who two weeks previously had given Watson CPR when his heart went into fibrillation, says her patient is doing “exceptionally well.”

“He’s right on plan to get out of here in probably under 14 days,” Bancroft says.

Watson, who had a pacemaker installed in 2006, suffered two “mini-strokes” in 2007, and had a defibrillating device implanted in 2011 which, combined with Bancroft’s CPR, saved him during the recent fibrillation incident.

A condition called dilated cardiomyopathy had bloated and weakened his heart. By the time he had the pump put in July 16, the organ was three times the normal size, allowing blood to stagnate, potentially forming stroke-causing clots.

Watson had been doing well until he contracted food poisoning on a family holiday in Mexico last year. The illness threw off his electrolyte balance, aggravating his myopathy.

“It was the enchilada,” he says from his hospital bed. “Nobody else in the family had the enchilada.”

The pump, turned on while Watson’s chest was still open during surgery The Province was allowed to witness last week, shrank his heart down to a more-normal size. Called a ventricular-assist device (VAD), the pump is connected to a battery pack via a cable that extrudes from a hole in Watson’s abdomen. The pack will be his constant companion.

“Patients are quite mobile with it,” says Dr. Anson Cheung, the world-renowned St. Paul’s cardiac surgeon who installed Watson’s device. “They can drive, fly. The quality of life improves significantly.”

At night, patients plug their battery pack into a wall socket. While driving, they can plug it into the vehicle’s electrical system.

Patients can go from being unable to walk from the bedroom to the washroom before installation of a VAD to being able to jog, says St. Paul’s cardiologist Dr. Mustafa Toma.

The cutting-edge pump Watson received — an $85,000 unit resembling a car’s gas cap with a stem on the bottom — is a major improvement on the technology of years past, Toma says.

“Before, the devices were bigger and more cumbersome,” Toma says. “[The new pumps] are less likely to fail, patients are less likely to get clots and patients are less likely to bleed.”

A VAD provides a bridge function: in general, the patient will still need a heart transplant, but the pump keeps them alive and able to keep up healthy levels of activity until a heart becomes available.

However, two St. Paul’s VAD patients are so comfortable with the devices that they plan to continue living with just the pump, rather than going through the stress of preparing for and having a heart transplant, says Annemarie Kaan, a nurse-specialist in the hospital’s heart-failure program.

VAD patients must take blood-thinning drugs.

“Blood tends to want to clot on mechanical devices,” Kaan says. “We have to keep blood thinner than in a normal person, usually twice as thin.”

Blood pressure pills are also prescribed, because the pumps don’t function well when the pressure is high, Kaan says.

“People go home from hospital on up to 16 medications,” Kaan says.

About 10 per cent of VAD patients recover and can have the device removed, with no need for a transplant, Kaan says.

Watson woke up from surgery “a little bit out of sorts” but thankful that chapter of his health saga was over.

“I knew I’d gotten through it, so I was happy,” he says.

He’s looking forward to being able to walk up stairs, and down the block, and to spend time with his kids, a boy, 9, and girls 11 and 13. He plans to work hard at rehabilitation, ratcheting up his exercise level each day.

While still at St. Paul’s, Watson will be trained on his VAD. Before going home, he’ll have to pass a test in which he switches over to the backup control unit in the carrying pack.

“It’s not that hard, but it’s stressful,” Bancroft says.

Watson’s wife, Maria, will receive the training provided to caregivers of VAD patients. “They need to know all the emergency stuff and what to do if something goes wrong with the patient or the machine,” Bancroft says.

Watson says he’ll return to work as a litigation lawyer as soon as he’s able, but will adjust his hours, either working less, or on a different schedule.

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